Posts Tagged ‘care news’

The UK care home sector is losing managers and failing to replace them, that was what LaingBuisson was telling the media more than 12 months ago. And guess what, it’s not changed today.

The shrinking pool of talent for the top jobs with providers of elderly care is driving manager salaries to new heights.

In the latest data I have to hand it says new-build homes are offering in excess of £60,000 a year for managers.

That means with the additional costs of National Insurance employer contributions, pension payments and other sweeteners, the source cost for providers is rapidly approaching £100,000, and a bonus scheme can easily tip this even higher.

Of course, we wouldn’t expect to see these figures being paid amongst many of our members and it’s not because they are mean employers. It’s a simple case of economics: There’s just not enough money in the pot as the region is too poor.

It’s a fact that many of the lager corporates operate in much more affluent areas than the West Midlands and unlike many here, their main trench of income is from private payers. Most of my members survive on council-funded placements and it’s their primary source of income.

In May last year, according to LaingBuisson Recruitment co-founder James Rumfitt, the residential care sector as a whole was struggling to find managers of competence.

I am not surprised.

According to the healthcare consultant’s Care Home Pay Survey – second edition, the average care home manager salaries at the beginning of 2015 were up 4.2 per cent above the previous year.

This was incredible 49 per cent higher than salaries seen a decade ago. Compared to an increase of just 24 per cent in median full-time employee earnings in the UK economy as a whole, it’s an eye-watering hike.

Isn’t it odd, the general care market is in turmoil, yet the economic dynamics of a shortage of good managers, pushes up their salaries at the top end of care provision. Supply and demand are hard masters.

While there will always be those who can afford private care payments and thus fund very generous salaries for the elite operators, there will be many more people receiving care on local authority rates only. Their care providers, where pay rates remain anchored to the Living Wage, will not have the privilege of top-ups to fund such salary extravagance..

But I must say this: The care I have seen in some of our struggling homes has been exemplary. Plush surroundings, teas on the terrace, matching furnishings and expensive, oak flooring, does not necessarily equate to excellence in care.

Fourteen doctors’ leaders have written to George Osborne asking for further funding for social care in next week’s Budget, the BBC has reported.

In a letter to the chancellor, they warn cuts in social care funding were putting real pressure on the NHS.

And they said investing in social care was “vital to the success of the NHS”. Err . . . yes.

The government response in the BBC report was that it was already giving local authorities access to up to £3.5bn of new funding for adult social care by 2019-20. By when? Far too late, I’m afraid.

The signatories to the letter are led by Clare Marx, president of the Royal College of Surgeons of England, and include the leaders of a number of royal medical colleges and societies.

In their letter to the Chancellor, they describe health and social care as “two sides of the same coin”.

It’s heartening that the letter describes the impact of an underfunded social care system on the NHS, saying patients fit to be discharged are unable to leave hospital because social support is unavailable at home. How long has the Association been saying this?

“This increases the likelihood of infections and falls,” the letter says.

The knock-on effect is that beds are blocked to new patients, they continue, “leading to cancelled appointments and operations”.

“This impacts on our ability to provide timely treatment and meet treatment targets, risking patient wellbeing, and is ultimately detrimental to the economy through delayed returns to work,” they wrote.

And here’s the bit I just love. In the letter, the doctors suggest bringing forward the extra £700m from the Better Care Fund to this year rather than waiting until 2017, when the money was due to be spread over three years.

NHS chief executive Simon Stevens has previously said that the success of the Five Year Forward View is dependent on adequate funding for social care.

The signatories to the letter are:

Miss Clare Marx, president of the Royal College of Surgeons of England

Prof Dame Sue Bailey, chairwoman of the Academy of Medical Royal Colleges

Prof John Ashton, president of the Faculty of Public Health

Dr Anna Batchelor, dean of the Faculty of Intensive Care Medicine

Dr Liam Brennan, president of the Royal College of Anaesthetists

Prof Jane Dacre, president of the Royal College of Physicians

Mr Michael Lavelle-Jones, president of the Royal College of Surgeons of Edinburgh

Dr Suzy Lishman, president of the Royal College of Pathologists

Prof Carrie MacEwen, president of the Royal College of Ophthalmologists

Dr Giles Maskell, president of the Royal College of Radiologists

Prof Neena Modi, president of the Royal College of Paediatrics and Child Health

Prof David Oliver, president of the British Geriatrics Society

Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists

Prof Sir Simon Wessely, president of the Royal College of Psychiatrists

Note: If this letter was on social media, I’d be adding my name to the list . . .

In any other scenario, you’d expect legal exchanges and the Press to be shouting ‘scandal’ from front pages.

But this is the care sector – often unde-gunned and always under-funded.

It’s incredulous, but has been claimed by reliable sources, that funds being raised by Dudley Council to shore up the costs of social care are to be used to help balance the books on the previous year’s overspend.

Under Chancellor George Osborne’s plan to fund care sector needs, he sanctioned a two per cent hike in council taxes during the Spending Review last November.

But it emerged at an emergency members’ meeting of the West Midlands Care Association, which represents private and charitable care providers, the new monies will have no impact on the current industry crisis that has seen 1,000 social care beds lost across the country since January.

Neither will there be any new monies generated for social care from Mr Osborne’s 2016 Budget proposals.

Hopes that he would heed calls by the Directors of Adult Social Services (ADASS) to bring forward £700m of social care funding never materialised.

Sadly, the outlook can only get worse as care providers struggle to make ends meet.

The West Midlands Care Association understands 50 per cent of the public in Dudley agree with the Chancellor’s precept of two per cent in the belief that it will help adults requiring social care packages to continue to receive them in a sustainable way.

But the truth is that the two per cent is just not enough and is being directed towards last year’s accounts shortfall.

How can they get away with this?

There are no provision margins from such funding for the current financial year.

A packed meeting at the Quality Hotel, Dudley, delegates from across the Midlands, heard the next three to four years would be “critical to the survival of social care as we know it.”

For the last nine years fees have fallen below the viable cost of running a care home.

Figures from Industry analysts LaingBuisson reveal English councils pay on average £91 a week less than what is needed to provide fully compliant care.

I’m sure the survival rate will tumble very soon as the living wage outlays start to hit home and the number of private funders, who shore up the shortfalls on the cost of care being paid for by local authorities, remain static.

At best, I believe, we have three to four years before the landscape of care changes beyond recognition and there will be no way back to the required bed levels our ageing population needs to provide some kind of fluid service to hospital discharge managers wanting to avoid bed blocking.

In a desperate attempt to secure a funding lifeline to the industry, MPs, councillors, local authority officers and Clinical Commissioning Groups (CCGs) have been asked to meet with us to discuss ring-fenced funding for social care. It’s the only way we’ll ever see any monies decanted from Government.

The vast majority of Black Country care businesses rely on placements paid for by councils as a primary income generator. More than 26,300 people across the region are receiving residential care. A similar number have care at home.

In September last year my association revealed Dudley Social services had given rises totalling 8.9 per cent over a five year period while, the Consumer Prices Index was at 11.6 per cent, the Retail Price Index at 15 per cent and wage rises hitting 12.3 per cent.

I’m wholly persuaded our local authorities understand the dilemma, but are working under a Government that is hopelessly adrift of reality.

Acknowledging the care sector is not in its finest hour, King writes: “My grandfather was a minister in the Church of Scotland, and he used to say to his congregation: ‘We must not succumb to hopelessness.’ It was his way of saying that we have to focus on the positives even when times are tough.”

King adds social care is perilously close to “succumbing to hopelessness”, yet despite unremittingly negative news, there are still remarkably good things happening in social care. Oh yes there are!

What I like about this article is that it is earthed in reality and the fears and dire warnings surrounding the care business are genuinely recognised.

Radical changes have not all been bad, he notes, encouraging “it is important to shout loudly about what is working well.”

A whole list of heartening examples follows and as pointed out, they are “the tip of the iceberg.”

King’s words are worth five minutes over coffee. Despite the gloom, media blame, financial turmoil, it’s not all bad. Go on, click the link, be inspired! and if you want more, do a quick search on my blog on the wedding.

What a surprise! Austerity measures have created a problem with councils’ ability to carry out research in adult social care.

I read one of the 104 respondents’ comments to the survey which said: “People who supported research and evidence-based decisions have been made redundant.”

Another claimed: “Research in ASC [adult social care] was the first thing to be cut as it is seen as non-essential and will continue to be cut in favour of services and care packages.”

The study, commissioned by the Personal Social Services Research Unit but carried out by the Social Services Research Group, clearly seems to state the obvious as councils struggle to balance their books. We know already that local authorities are between a rock and a hard place.

Focussing on survival mechanics, however, always comes at a price. Expendable research? Probably not, though I’m well aware that duplication is a major problem in the industry and I can understand if local authorities can lock into other information streams their decision-making process on these redundancies.

Without research we have no way of knowing the how and why services are delivered and what difference they make

Without research how can we accurately set budgets and map for the future?

It needs to be done by someone. Without research we are running blind. Finally, can someone tell me please why such few numbers of me ever go into residential care?

Like over-prescribed antibiotics, graphic descriptions of the current care crisis fail to have the desired effect when they become a daily prescription of the news.

I fear many are becoming anaesthetised – indeed, almost indifferent – to the digest of chaos emerging from the sector.

In a joint submission to the Treasury ahead of November’s Spending Review, 20 organisations say the care sector is facing a “deepening crisis”.

Yes, it surely is!

They have called for funding to councils to be protected, as is happening with the NHS, a move that my own WMCA has also taken.

Ministers said investment in health would also benefit the care sector.

The government has pointed out that plans were being put in place to ensure greater joint working between the two sectors and that would relieve some of the pressures.

But those putting their names to the latest warning – leaders of councils, the NHS, care providers and charities – are not convinced the future is safe.

They say the market is “fragile” with councils forced to keep fees low and providers leaving the care sector; this, they add is driving up prices for those who fund themselves and leading to fewer people getting state-funded support.

Let me quote The Guardian piece: “While the government has pledged an extra £8bn a year for the NHS by 2020, social care has received no such assurances.”

Ray James, president of the Association of Directors of Adult Social Services, one of the signatories to the submission, is reported as saying: “It is vitally important that this year’s Spending Review understands the importance of our services to vulnerable people,” adding that the “near-certainty” is that without adequate and sustained finances the ability to carry out their duties will be in jeopardy.

The Care Providers Alliance, adds that the challenges are on an “unprecedented scale,” while Rob Webster, chief executive of the NHS Confederation, which represents health service managers, says: “Having a shiny NHS cog will be no good in a broken health and care machine.

“All these services are interconnected and all need greater financial certainty.”

I’d like to know who the other signatories are, but I think we get the message anyway. . . let’s hope those with real influence for change also do.

We have heard so much now of impending doom, I fear our message is in danger of becoming white noise. Prescribing the antidote when the patient is dead presents an obvious problem.

Like countless others in the care sector I have joined the chorus in the West Midlands calling on councils to pay a viable rate for care beds purchased from the private, charity and voluntary sectors.

The care landscape is bleak and my WMCA has warned closures are imminent and there is little regional capacity to take up those frail and needy residents who may be displaced. To this end we are desperate to work with local authorities to find mechanisms that will secure the future care of the most vulnerable and the survival of local businesses.

At an emergency meeting of the association, members heard George Osborne’s living wage directives could “be the final nail in the coffin for care as we know it.”

In an attempt to secure a funding lifeline to the industry, we are calling on MPs, councillors, local authority officers and Clinical Commissioning Groups to meet with us to discuss future ring-fenced funding for social care.

The vast majority of Black Country care businesses rely on placements paid for by councils as a primary income generator and more than 26,300 people across the region receive residential care. A similar number have care at home.

In recent weeks, five care home corporates with 1,200 properties between them have written to the Chancellor warning of impending disaster following his Budget reforms on the living wage.

The big five – Four Seasons Health Care, Bupa UK, HC-One, Care UK and Barchester – look after 75,000 frail, old people. They claim a major provider is likely to close within a year to 24 months unless the Government releases its purse strings. The response: Silence.

The national picture is indeed gloomy, but in our region it’s much, much worse and Osborne’s announcement has caused shockwaves across the region. So many are already in crisis . . . and now this.

The legislation impacts massively on all streams of care as indeed it must doe with many other businesses.

A WMCA impact analysis suggests the Osborne wages regulation will add £23 per week to the care cost of every Midlands person in a residential care setting. But we need to add to that figure a further £50, the current average weekly operational deficit on council-funded places.

If the corporates – HC-One is one of our members – are predicting at best only a two-year survival rate under current economies, what chance have my other members, who have much smaller homes and much-depleted resources?”

Residential care occupancy levels throughout the Midlands are averaging 97 per cent and there’s not not a member in the association who is not anxious about the future wellbeing of those requiring care.

For those who think we do not want to pay the living wage, think again, please. All of my members would happily apply the living wage, but there is no financial sleeve left in their business models to do so. Care home companies are not just crying wolf. Care is a minimum wage industry and profit margins are extremely tight, especially where council referrals are the main income.

Do you know that for the last nine years fees have fallen below the viable cost of running a care home?

Over the last five years, for example, Dudley Social services has given rises totalling 8.9 per cent while the Consumer Prices Index is at 11.6 per cent, the Retail Price Index at 15 per cent and wage rises are hitting 12.3 per cent. The rises don’t track cost and we clearly need some Government benevolence to help both councils and care providers.

Recently Sandwell Council’s cabinet met to respond to a WMCA call for a fees increase of 16 per cent – residential care from £378 per week to £438.46; dementia care from £428 per week to 496.48; and residential nursing care from £490 per week to £568.00.

What do we get? A 1.5 per cent rise for residential care and a 2.5 per cent rise for nursing.

Latest figures from Industry analysts LaingBuisson reveal English councils pay £91 a week less than what is needed for fully compliant care.

In 2013 Birmingham City Council commissioned accountants and analysts KPMG LLP to establish the true cost of care through the Open Book initiative where care providers were asked to submit their accounts.

Some 380 homes were targeted and the results showed to meet escalating costs commissioners would need to pay £460 per week.

Two years on, and not including the implications of the living wage, It would take an l increase of six per cent to bring homes to the minimum figures used by the Association of Directors of Adult Social Care (ADASS) as the threshold for safe care announced this spring. An extra three per cent would allow homes to cover increases in operational costs.

Sadly, if a major employer were to make this kind of warning there would be huge interest over the potential loss to the economy. What we have here is a bunch of businesses across the region that create about 125,00 carer jobs for adult social care (figures from Skills for Care).

“That dwarfs the employment stats of say Jaguar LandRover and it’s deeply worrying that few of these jobs are secure under present funding models.

Listen, councils do have choices what to do with funds and government austerity can no longer be an excuse for not addressing the finances of care.

I would call upon our local councilors to make decisions of conscience on funding that will directly impact on the most vulnerable people in the electorate they serve.

It is a fact that a dog walker can earn more than we can pay our carers. There is something radically wrong.